This invention relates to a method of and a system for the treatment of periodontal disease, and, in particular, to the delivery of medication directly to the source of the infection.
Periodontal disease may be caused by microbes utilizing food which is impacted into the gingival crevice or by occlusal trauma. Periodontal disease may also be caused by restorations having rough edges or interproximal overhangs which allow for the build up of bacteria on the rough edges or around the margins of the excess material of the overhang or other causes. Periodontal disease may result in inflammation of the gingival unit and may extend to the periodontal ligament, the aveolar bone and the cementum. It may lead to loss of clinical attachment and aveolar bone, ultimately resulting in the loss of teeth and the need for dental prosthesis.
Several methods have been used to treat periodontal disease. These include root planing, gingivectomy, chemical wettage, and osseous resective surgery. Root planing, gingivectomy and osseous resective surgery all involve surgical removal of infected bone or tissue. Chemical wettage involves the delivery of a solution of various agents, e.g., Vitamin C and hydrogen peroxide, to the infected area by irrigation, syringe or rinse. A topical tetracycline rinse has also been used. The chemical wettage solution and tetracycline topical rinse have been used in combination with other medications to impede bacterial and microbal growth and to allow healing. However, because of the delivery methods used with these prior chemical wettage and topical rinse treatments, these treatments generally have not been effective in the treatment of periodontal disease.
Heretofore, cords chemically treated or impregnated with medicaments (e.g., tetracycline or other agents) have been applied under the gingiva by a dentist. Typically, a small length of such chemically treated cord is forced under the gingiva and allowed to remain in place for an extended period of time (up to ten days or so). It is necessary for the dentist to remove these cords.
The prior art discloses many methods of delivering a medicament for the treatment of periodontal disease. U.S. Pat. No. 3,844,286 to Cowen, U.S. Pat. No. 3,964,164 to Hesselgren, and U.S. Pat. No. 4,411,889 to Caslavsky et al. disclose methods and devices for the topical delivery of medication to the teeth, gums, and pockets. Cowen uses a flexible I-beam shaped foam bar which may carry a fluoride, a phosphate, or an antibiotic. The medication which is carried by the bar is released by mastication (biting) pressure. Hesselgren uses a moldable carrier, such as wax or rubber, which includes an activator. Medications, such as fluoride, are mixed in with the carrier which is then applied to the outside of the teeth and gums using a mold to form a molded mass around the teeth. Caslavsky et al. discloses a self-gelling aqueous solution which topically delivers fluoride, antibiotic, or antibacterial agents. These above-mentioned prior art patents concern the delivery of a medication to the tooth, gums, or periodontal pockets. However, none of the prior delivery methods delivered the medication directly to the source of the infection near or at the bony structure supporting the teeth.
EP Pat. Appln. No. 0,114,113 to Wiley discloses a wooden cleaner for removing material from periodontal pockets, sulci, and tooth surfaces. The cleaner may carry antibiotic medicaments for delivery to the pockets. However, because of the the relative non-absorbent characteristics of the wooden cleaner and the slow rate at which a wooden carrier would release the medication, this delivery device is not believed to be capable of delivering sufficient quantities of the medication. This delivery device is further believed to be unsuitable because it would be difficult to make it flexible enough to deliver medication to the bony structure.
U.S. Pat. No. 4,162,688 to Tarson et al discloses a device for applying medication, generally, fluoride, to dental floss. Although the dental floss is flexible, Tarson et al do not disclose direct delivery of medication to the bony structure, and the floss disclosed is not sufficiently absorbent to hold an adequate amount of medicament to be effective.
The dental community has recognized the need to regenerate the support structures of the teeth in the treatment of periodontal disease. In the October, 1989 issue of the Journal of the American Dental Association, at page 484, it is reported that researchers have been using highly osteogenic materials to promote bone regeneration. Such materials include demineralized freeze-dried bone, allograft or cancellous bone and marrow, which, when placed in subcutaneous tissue, promotes bone formation. Other research involves the use of human bone proteins to initiate or enhance bone regeneration.
None of the above references disclose a simple method of treatment, which a patient can self-administer, that will cause the bony structure supporting the teeth to regenerate in order to permit healing of the periodontal disease or to reduce the necessity of or the invasiveness of periodontal or oral surgery.